Could “Eccentric exercises” be a magic cure for tendonitis?

Tendonitis can be a right pain.  There are tendons in the human body wherever muscles meet bones, connecting the two together.  This creates lots of opportunity for pain, stiffness, grating sensations and swelling: all classic symptoms of tendonitis. Two very well-known types of tendonitis are Tennis elbow and Achilles tendonitis.

It’s often possible to attribute tendonitis to a particular injury e.g. a particularly strenuous game of tennis when you suddenly felt pain in your elbow tendons.  If you feel tendon pain or swelling after such an injury always adopt the RICE methodology first:

  • Rest from the activity which caused the issue
  • put Ice on your injured area for up to 20 mins every 2 to 3 hours,
  • Compress the injury with a bandage
  • Elevate the injured area on a pillow when sitting or lying down

Painkillers can also help get you through the initial painful period – ask your pharmacist for their recommendation.  If these aren’t helping or you think the injury could be more serious, it’s time to get yourself to a GP or minor injuries unit.

If the pain starts to linger for more than a couple of weeks, this could also be the time to seek further advice.  At this point you might want to also consider osteopathy or physiotherapy.

So what do eccentric exercises have to do with tendonitis?

Eccentric exercises are a progressive treatment for tendonitis that a lot of manual therapists are turning to because they have proven results and are non-invasive.  Here’s the theory of how they work.

Muscles are basically divided into two sections. The contracting (red) muscle belly and the (white) tendon and non-contracting parts.

Muscle shortening (concentric contractions) stresses and thereby strengthens the red muscle belly.

Active muscle lengthening (eccentric contractions) stresses and thereby strengthens the (white) tendon tissue more.

To give you an example: your calf muscle shortens to rise onto your toes but lengthens to control your descent. The lowering phase is an eccentric contraction.

Eccentric exercises have been designed to strengthen the tendon and non-contracting muscles.  The proven effect of this is that it helps swollen tendons return to normal, thereby alleviating tendonitis.

If your osteopath or physiotherapist decides that eccentric excises are an appropriate treatment for your tendonitis they will create a programme of exercises for you.  To give you a flavour of these exercises, for Achilles tendonitis, you can expect exercises such as heel raises with straight legs and bent legs.  Simple – but powerful.

Unfortunately, eccentric exercises won’t be a magic cure for everyone… but approximately 70% of sufferers respond well to it, which is a very reassuring statistic.  The not-so-good news is that it will take commitment to your exercises to see that change, however, we are only talking about working up to about 6 minutes of exercises per day.  You can also expect it to take 3-6 months for symptoms to be significantly improved, but it can be quicker than that.

We hope you’ve found this article of use.  Please contact us if you would like to find out more about how our physiotherapy and osteopathy service can help with tendonitis.